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Prevention of relapse or failure after CD19-targeted CAR T-cell therapy
Source: Childhood Acute Lymphoblastic Leukemia Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: April 21, 2025 · Captured 2026-09-09.
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Investigators have examined several strategies to prevent relapse after initial CAR T-cell infusions. These strategies include repeating CAR T-cell infusions for various indications and risk groups, giving maintenance chemotherapy, and infusing a different type of CAR T cell.[185,198]
Second infusion of the first CAR T cells.
Second infusion of the first CAR T cells.
A retrospective study from the Children's Hospital of Philadelphia analyzed the outcomes of 81 repeat CAR T-cell infusions (CARTr) for three indications: (1) relapse prevention in at-risk patients (peripheral B-cell recovery [BCR] or emergence of CD19-positive hematogones), (2) CD19-positive MRD emergence or relapse, and (3) failure to go into remission after initial CAR T-cell infusion.[199]
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Second infusion of the first CAR T cells. › A retrospective study from the Children's Hospital of Philadelphia analyzed the outcomes of 81 repeat CAR T-cell infusions (CARTr) for three indications: (1) relapse prevention in at-risk patients (peripheral B-cell recovery [BCR] or emergence of CD19-positive hematogones), (2) CD19-positive MRD emergence or relapse, and (3) failure to go into remission after initial CAR T-cell infusion.[199]
Of 63 patients who received CARTr for relapse prevention, 52% achieved CR (BCR, 15 of 40 [38%]; hematogones, 18 of 23 [78%]).
Second infusion of the first CAR T cells. › A retrospective study from the Children's Hospital of Philadelphia analyzed the outcomes of 81 repeat CAR T-cell infusions (CARTr) for three indications: (1) relapse prevention in at-risk patients (peripheral B-cell recovery [BCR] or emergence of CD19-positive hematogones), (2) CD19-positive MRD emergence or relapse, and (3) failure to go into remission after initial CAR T-cell infusion.[199] › Of 63 patients who received CARTr for relapse prevention, 52% achieved CR (BCR, 15 of 40 [38%]; hematogones, 18 of 23 [78%]).
Lymphodepletion was associated with response to CARTr for BCR (odds ratio [OR], 33.57; P = .015) but not hematogones (OR, 0.30; P = .291).
Second infusion of the first CAR T cells. › A retrospective study from the Children's Hospital of Philadelphia analyzed the outcomes of 81 repeat CAR T-cell infusions (CARTr) for three indications: (1) relapse prevention in at-risk patients (peripheral B-cell recovery [BCR] or emergence of CD19-positive hematogones), (2) CD19-positive MRD emergence or relapse, and (3) failure to go into remission after initial CAR T-cell infusion.[199] › Of 63 patients who received CARTr for relapse prevention, 52% achieved CR (BCR, 15 of 40 [38%]; hematogones, 18 of 23 [78%]).
The cumulative incidence of relapse was 29% at 24 months for CR, compared with 61% for nonresponse to CARTr (P = .259).
Second infusion of the first CAR T cells. › A retrospective study from the Children's Hospital of Philadelphia analyzed the outcomes of 81 repeat CAR T-cell infusions (CARTr) for three indications: (1) relapse prevention in at-risk patients (peripheral B-cell recovery [BCR] or emergence of CD19-positive hematogones), (2) CD19-positive MRD emergence or relapse, and (3) failure to go into remission after initial CAR T-cell infusion.[199]
For MRD/relapse, the CR rate after CARTr was 50% (5 of 10). However, no CRs were observed in the eight patients who had their initial CAR T-cell infusion fail.
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